October 20, 2016

Research fuels smarter medicine

The Department of Research & Evaluation’s 2015 Annual Report details, through stories and statistics, how the connections between research and clinical practice result in smarter medicine at Kaiser Permanente.

“Our research studies span the full spectrum of care, from prevention to treatment and beyond,” wrote Senior Director of Research Steven J. Jacobsen, MD, PhD, in the report’s introduction.

Kaiser Permanente has seven regional research centers and one national center. Each contributes to the excellent care provided throughout the Kaiser Permanente program. At the Department of Research & Evaluation in Southern California, there is an emphasis on research that can directly improve patient care.

Hospital stays and flu vaccine

When some clinicians were concerned that flu vaccinations could cause issues for surgical inpatients, research was done to determine if that were true. The Kaiser Permanente study found that surgical patients who received the flu vaccines during their hospital stay had no increased risk of emergency department visits or subsequent hospitalizations in the week following discharge.

Bruno Lewin, MD, a family practice physician at the Kaiser Permanente Los Angeles Medical Center, said that encouraging surgeons to give flu vaccines to their patients became much easier after the research was published.

“It’s much harder to argue with data that come from your own patients,” Dr. Lewin said.

Reinforcing value of online tool

Another story in the Annual Report examines Kaiser Permanente Southern California’s Online Personal Action Plan, or oPAP. The online action plan provides patients with personalized information about when they are missing important screenings and resources for improving, such as smoking cessation classes.

The evaluation showed that people who used oPAP closed care gaps at a higher rate than those who didn’t use it. For example, patients who used oPAP were 9 percent more likely to receive a mammogram and 12 percent more likely to schedule and complete routine blood sugar (HBA1c) tests.

“The study helped us focus in on areas where we know we can make a bigger difference,” said Andre Ahuja, MSc, assistant director for the Complete Care Support Programs.

Detecting eye conditions One story in the Annual Report explores the innovative Kaiser Permanente Southern California Eye Monitoring Center. The Center was established with the goal of standardizing the evaluation of retinopathy – a condition often seen in the eyes of patients with diabetes and that can lead to blindness. Before the center opened, ophthalmologists and optometrists in each medical center read images of patients’ eyes and provided the results. After the center opened, certified ophthalmic assistants at a central location provided results instead.

Research showed that the proportion of patients detected with diabetic retinopathy increased from about 10 percent to 25 percent after the change, allowing more patients to receive appropriate education and treatment.

Other stories in the Annual Report focus on how:

  • Innovations in detection and treatment of lung nodules change medicine.
  • Comparing the effectiveness of different surgical techniques and technologies drives improvements in surgical care.
  • Life after cancer is improved because of research.
  • Gestational diabetes could be related to autism.
  • A new grant will help fund the quest to reduce diagnostic errors.
  • Research bolsters clinical excellence

    The Department of Research & Evaluation Annual Report also provides overviews of its research program, funding, biographies of investigators, and references to the 414 studies published in 2015.

    “Kaiser Permanente’s approach to evidence-based medicine is about finding smarter ways to practice medicine,” Dr. Jacobsen said.

    Read the full report.